A simulation case study to improve staffing decisions at mass immunization clinics for pandemic influenza
A simulation case study to improve staffing decisions at mass immunization clinics for pandemic influenza
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DOI：
10.1057/jors.2013.148
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发表时间：
2014-04-01
影响因子：
3.6
通讯作者：
Carter, Michael W.
中科院分区：
文献类型：
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作者：
Beeler, Michael F.;Aleman, Dionne M.;Carter, Michael W.
大规模免疫接种诊所（MIC）是许多辖区大流行性流感控制战略的重要组成部分。关于中等收入国家人员配备水平的决定影响公共卫生当局关注的几个因素：疫苗接种总量、患者等待时间、运营成本和设施内流感传播风险。我们对MIC进行了离散事件模拟，以评估人员配置变化对这些因素的影响程度。模拟是基于加拿大诊所应对2009年H1N1流感大流行的数据。这项研究是第一个在MIC模拟流感传播风险的研究，也是第一个将这种风险与人员配置决策联系起来的研究。我们发现，如果不考虑间接等待成本和设施内感染，增加工作人员的边际效益被大大低估。
Mass immunization clinics (MICs) are an important component of pandemic influenza control strategies in many jurisdictions. Decisions about staffing levels at MICs affect several factors of concern to public health authorities: total vaccination volume, patient wait-times, operating costs, and intra-facility influenza transmission risk. We present a discrete-event simulation of an MIC to assess how strongly staffing changes affect these factors. The simulation is based on data from Canadian clinics responding to pandemic H1N1 in 2009. This study is the first to model flu transmission risk at an MIC, and the first to relate such risk to staffing decisions. We show that the marginal benefit of adding staff is greatly underestimated if indirect waiting costs and intra-facility infections are not considered.